Impact of body habitus on single-site laparoscopic appendectomy for nonperforated appendicitis: subset analysis from a prospective, randomized trial.

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DOI: 10.1089/lap.2012.0056


INTRODUCTION: There have been several series documenting the utility of single-site laparoscopic appendectomy. However, there are no data to support patient selection based on their physical characteristics. We recently completed a large prospective, randomized trial comparing single-site laparoscopic appendectomy with standard three-port laparoscopic appendectomy for nonperforated appendicitis. This dataset was used to examine the relative impact of body habitus on operative approach.

SUBJECTS AND METHODS: We performed an analysis of the dataset collected in a prospective, randomized trial of 360 appendectomy patients who presented with nonperforated appendicitis. Body mass index (BMI) was calculated and plotted on a growth chart to obtain BMI percentile according to gender and age. Standard definitions for overweight (BMI 85-95%) and obesity (BMI >95%) were used.

RESULTS: In the single-site group there were 26 overweight and 19 obese patients. In the three-port group there were 25 overweight and 16 obese patients. There were no significant differences between overweight and normal with either approach. However, with the single-site approach there was longer mean operative time, more doses of postoperative narcotics given, longer length of stay, and greater hospital charges in obese patients. In the three-port group, there were no differences between normal and obese patients.

CONCLUSIONS: When using the single-site approach for appendectomy, obesity in children creates longer operative times, more doses of postoperative analgesics, longer length of stay, and greater charges. However, obesity has no impact on three-port appendectomy.

Journal Title

Journal of laparoendoscopic & advanced surgical techniques. Part A





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MeSH Keywords

Appendectomy; Appendicitis; Body Mass Index; Child; Female; Humans; Laparoscopy; Length of Stay; Male; Obesity; Overweight; Prospective Studies; Surgical Wound Infection; Treatment Outcome


Appendectomy; appendicitis; Body mass index; obesity; Surgical Wound infection; Treatment outcome

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